Neurological Insight Needed

[Hunter11]

I brought my 14 year old gelding to a clinic recently for an exam after a particularly violent stumble after a pole the other day. This has happened two other times, starting in May 2020 - a stride after a 3’ jump and in November 2020 a stride after a 2’6” jump. The first one we wrote of as a freak thing - slightly slick footing, just something bizarre that didn’t happen again and he didn’t exhibit any other symptoms or odd behavior until he started swapping off the right lead constantly on the flat.

I had the vet out and injected hocks and then stifles after it didn’t resolve. It slowly became better but arised every once in a while. He had no issues until August 2020 when he became uncharacteristically spooky. I had the vet out and she pulled vitamin E and selenium levels which were normal. He slowly just went back to his normal self.

After he stumbled hard (both times to his knees) a stride after the jump again in November, I had the vet out again and determined he was foot sore and had mild navicular in his front right. She did a neuro exam each time she was out and never found anything. Changed shoes and that seemed to have solved the problem. He was feeling amazing under saddle, coming out of his stall and immediately moving and jumping like a 10. I thought the problem was solved until last week when it happened again over a pole and it became clear this had become a habit that was NOT resolved and very dangerous.

I took him to the clinic and the vet was suspicious for neuro after the in-hand exam and after showing no acute lameness during the lameness exam with flexions. I have scheduled him to see Dr. Amy Johnson at New Bolton which I have heard amazing things about but it is not for another few weeks. The vet tossed around EPM, Lymes, EDM and spinal compression. She obviously advised me to not ride him which I absolutely was not planning to do.

I have not known any neuro horses so this is all new to me so forgive me. From my research, EDM is typically really only diagnosed in older horses, correct? I just don’t know, nothing seems to match perfectly but I guess nothing is textbook when it comes to these things. I know only a specialist and further testing can offer me answers but I’m just heartbroken at the thought of retiring him or something worse. I lost my 7 year old gelding just three years ago tragically and I am trying not to jump to conclusions but also prepare myself that there is a possibility that he will never be safe to ride.

Any insight is welcome. Thank you for reading.

[Peggy]

Welcome to the forum @Hunter11!

EDM typical shows up in younger horses than yours.

Glad to hear you’re taking the horse to New Bolton. Hopefully that will give you some answers, or at least more data.

Sounds like you might be dealing with ouchy feet? Maybe in addition to something else.

A friend’s horse started to fall as it took the first stride after a jump. It was the neck and the vet felt that something got pinched as the horse raised its head to commence that first stride after the jump. This horse was a few years younger than yours.

Good luck, and please come back and update.

[Hunter11]

Thanks Peggy, I appreciate the warm welcome and insight. What ended up happening with your friend’s horse?

[JB]

@Hunter11

EDM

Did you test his Vit E level as well?

Lyme would be more common than EDM, and like Peggy said, EDM usually shows up in MUCH younger horses - like foal/still growing age.

I also wouldn’t expect EDM to come and go like these symptoms have, but Lyme can absolutely cause intermittent stability issues, as can EPM.

I hope you an answer that can be managed!

[Hunter11]

Thank you, I hope so too. Yes his Vit E levels were normal when I had blood pulled when he was being spooky in late summer. She only tested vitamin E and selenium which were normal but he went back to his normal self and I didn’t press the issue.

The vet didn’t think it was EPM for some reason. No real behavioral changes besides the bout of spookiness and he is certainly not dull. But it seems like it can really range from horse to horse. It almost sounded like she was leaning more towards EDM which is confusing to me after reading more about it.

Thank you for the insight and well wishes.

[JB]

Something else to consider is xraying the neck to see if you’ve got cervical issues that maybe only become a problem when he moves a certain way.

[Hunter11]

Definitely - they will be performing radiographs, spinal tap, mylogram, and robotic CT at the end of April. I guess I am looking for any experiences and insight in the meantime while I’m playing the waiting game and my mind is racing.

[2tempe]

Some years ago my (dressage) horse was diagnosed with cervical arthritis. One of the first signs was inability to maintain one lead at the canter. Some other slight neuro changes evident in in-hand evaluation. He was 20ish at the time. Neck injections helped quite a bit and he was rideable for at least another year or so, though not at his previous level of training. At that point he was having trouble with one stifle, leg kept getting “left behind”. He was still ok when on lunge line or in round pen but the weight of saddle and rider was a problem. CA would be consistent with some intermittent signs especially early on.

[No1]

Cervical arthritis can be really, acutely painful and only really seen when a horse moves their neck in a certain way. I’ve seen multiple horses have good results with neck injections.

As your horse is 14 and has only started having issues in the last year, I wouldn’t be super concerned yet about long term rideability. True wobbler’s is usually diagnosed in young and growing horses. I know of one who was diagnosed in his teens, kind of by accident, and he kept in work any way. He wasn’t falling down and had been competing successfully at a high level before his diagnosis.

[Peggy]

@Hunter11

Thanks Peggy, I appreciate the warm welcome and insight. What ended up happening with your friend’s horse?

That horse was euthanized as it was not considered safe to ride and they felt the quality of life would not be good much longer.

I’ve had two. One (Skipper) was wobblers. He never tripped or fell, but kept making himself lame. After rehabbing once, including a year totally off, restarting him when he was six, and then having all the prior lamenesses return, I euthanized him shortly after his seventh birthday. He was a sweet, kind horse who was starting to have episodes where he’d freak out. Apparently they can get a stinging feeling in some situations if they move their neck the wrong way, so maybe that was going on with him. Several horses from that breeder (not of warmbloods, came to a similar end.

With the other (Star) we found neck issues when he was 12 while diagnosing a front leg lameness that had recurred. This horse had tripped pretty consistently his whole life under saddle, but we just thought he was klutzy. For perspective he was born in 1999 and neck issues weren’t considered as much. Anyway, we treated the neck with IRAP injections, got the other issues cleared up, and I was able to ride him on the flat. The issues got to hard to manage, the horse was not happy, and I retired him when he was 14. I still wonder if the outcome would have been better if we’d found the neck issues on the first go round of the lameness when he was 9 but I foolishly didn’t have the whole horse scanned the first time.

I provided the names in case anyone wants to search here as I’ve written about both. I thought of the first horse, not mine, initially bc of the similarity with tripping after landing from a jump.

[Hunter11]

Thank you for that info, I will do some more searching on the forums. Im so sorry to hear what you went through with your horses. I’m afraid my horse sounds more similar to your friends. I should note the falls were very serious. The stumbles were violent although he didn’t show any noteworthy amount of tripping on the flat. I broke my knee cap in November and my nose last week. First time it happened I somehow managed to stay on. I probably sound very ignorant for continuing to ride until it happened a third time but he was cleared neurologically by my local vet and we were convinced the problem was his feet and that the problem was fixed until last week.

I’m devastated that these falls have happened and just at the thought of having to retire him early or worse. In addition to being my dream horse that I felt came at the exact right time after losing my young horse, I’m an adult ammy working in corporate and one horse is my financial limit — so I also fear I will not only grieve the loss of my most special riding partner, but my overall riding career. I am getting ahead of myself of course, but I can’t help but fear the worse and need to be prepared for that possibility. I am just PRAYING that this is something treatable.

[IPEsq]

My guy started having these episodes. Even fell to his knees during ridden part of a vet exam for the issue when he tried to stop to poop. Vets could find nothing wrong. His neck X-rays and ultrasound are perfect (had a neck horse before, so not my first rodeo!). EPM negative, vitamin E and Se normal. Vitamin E actually If anything a little high.

He’d also been having these hind end weaknesses. He was tripping up front because he was just loading himself so much in the front end and rooting a lot too. He was also getting spookier but overall seemed like he was getting kind of shut down.

I kept having the vets out again and again and again. I said, we just schooled a half canter pirouette however many weeks ago and now I’m scared that if we canter we will face plant. Something is wrong! I was told he was sound. We scoped his airway in case the posture thing was related to that. Blocked the front limbs. Injected hocks. Nothing. I think he was making his front feet sore at one point but pads fixed that.

First nugget of positivity was an intense nose to tail chiro session made him feel a lot better. And more of them kept him rideable. So I knew we had to keep looking at the axial skeleton.

Turns out it’s an SI injury causing some bony remodeling but without any apparent ligament injury, and he also seems to be having some nerve twinges related to that due to his last 2 lumbar vertebrae being totally fused, like pre-sacrum.

Many months later, I’m still working on it. The rehab has been difficult but the prescription is in part conditioning, not chucking him in a field.

Anyway, it was surprising for it to be in the back but not kissing spines and not neck problems.

[Critter]

I really hope it ends up not being EDM…I never thought I would wish so hard to have my horse diagnosed with EPM or Wobblers. Instead we got the diagnosis of EDM back in February. My guy was just turning 5.

I will say that Dr. Johnson is absolutely the BEST…she is an exceptional clinician and just a kind and caring person. Your horse will be in the best of hands…even if you don’t get a diagnosis you want. My guy had sudden explosive spookiness, both under saddle and on the ground (even when out in his turnout)…he was always a bit sensitive, but never explosive. We did have a few bad trips…one he tore his front shoe clear off. But we always chalked it up to being an 18h 4yo. He wasn’t overtly neurologic in the beginning. We initially started with stifle issues…then on/off front end lameness that came and went. His vitamin E level was normal on one test, slightly low on a later test.

We did testing for Lyme and EPM before he went to NBC just to get a head start. I really thought we were going up for a Wobbler diagnosis…though in my mind, I knew the EDM was more likely due to the behavioral changes. I said goodbye on Feb. 9th…a month later we got the pathology report back and it confirmed bilateral brainstem axonal degeneration. I’m crying just typing this up…I would have done anything to fix him. There is a Facebook group for people with horses dx with EDM to share experiences.

[VaGirl]

We have an appointment with Dr. Johnson next Monday. My seven year old has never been quite right and the past year his performance and behavior have changed radically. He had begun exploding under saddle for no reason and his spookiness has definitely gotten worse. The sports medicine doc here found kissing spines (with bone on bone) and cervical arthritis in c6,7. He was injected about two months ago and his behavior has gotten worse. Leading to and from the turn out can be a challenge with rears and bolts and he doesn’t handle any type of body work very well. EDM has been mentioned but he doesn’t seem to be neurological at this point. I’m hoping to get answers; at the same time I’m scared of what those might be.

[joiedevie99]

I would be suspicious of neck arthritis with that description.

I’d highly recommend you talk to the vet at New Bolton and see if you can get the blood tests run for Lyme and EPM before you go, so you have results in hand for the appointment. It makes it so much easier to make decisions about further diagnostics.

[Hunter11]

Thanks for your insight. Because blood tests only show if he was exposed to EPM/Lymes, they will need to compare both the spinal tap results with blood so I think that makes more sense so I’m not paying to have my local vet pull it and then NB pull it as well. It might give me minor direction if it’s negative but I think there’s a good chance it will be positive due to the area we live in.

[Hunter11]

So sorry for what you are going through and sending jingles for your boy. I have heard amazing things about Dr. Johnson both as a vet and person so I am sure our horses will be in the best of hands. I hope you get the answers you are looking for.

[Amy3996]

Glad to hear you’re heading to New Bolton. I just took my guy there for a workup and I couldn’t have been more impressed. They were so thorough with his diagnostics and patient/friendly with me.

I know EDM typically presents in much younger horses, but I know of two currently who developed symptoms at 5. One was euthanized back in February and confirmed to have EDM on necropsy. The other has worsening neurologic deficits but is negative for Lyme/EPM, etc. Both have had episodes of explosive spookiness and ataxia. I sincerely hope that whatever is ailing your horse is treatable. It certainly sounds like ruling out EDM would be wise though.

[VaGirl]

You will love Dr. Johnson! We were able to attend the neuro exam yesterday morning and she spent a lot of time listening and then explaining what she observed. She laid out a clear plan for diagnostics to rule out any other issues Henry might have. Unfortunately for us, I don’t think we’ll have a happy ending, she strongly suspects EDM, but we are confident that we are exploring any other causes for his issues. He definitely showed more neuro signs than he had in previous exams. Myeologram today with spinal tap for EPM and Lyme.

I hope for good results for your guy, there are many things that are treatable or manageable. Please keep us updated - but you will absolutely be in the best hands possible.

[awaywego]

It really says so much about Dr. Johnson that she handles so many negative outcomes with such grace. I don’t know how she does it. (I also really appreciated her despite a sad outcome for my horse too.) I’m grateful that we live close enough to be able to seek her expertise for these difficult diagnoses.

Good luck!